Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 163W00000X | Registered Nurse | | | | No |
| 2 | 163WI0500X | Registered Nurse | Infusion Therapy | | | No |
| 3 | 1835C0207X | Pharmacist | Compounded Sterile Preparations | | | No |
| 4 | 1835P0018X | Pharmacist | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | | | No |
| 5 | 207Q00000X | Family Medicine | | | | No |
| 6 | 207R00000X | Internal Medicine | | | | Yes |
| 7 | 251F00000X | Home Infusion | | | | No |
| 8 | 332B00000X | Durable Medical Equipment & Medical Supplies | | | | No |
| 9 | 332BC3200X | Durable Medical Equipment & Medical Supplies | Customized Equipment | | | No |
| 10 | 3336C0002X | Pharmacy | Clinic Pharmacy | | | No |
| 11 | 3336S0011X | Pharmacy | Specialty Pharmacy | | | No |